Policy Effects of Secondhand Smoke Exposure in Public Places in the Republic of Korea: Evidence from PM2.5 levels and Air Nicotine Concentrations

Objective: The purpose of this study was to evaluate secondhand smoke (SHS) exposure inside selectedpublic places to provide basic data for the development and promotion of smoke-free policies.
Methods: BetweenMarch and May 2009, an SHS exposure survey was conducted. PM2.5 levels and air nicotine concentrations weremeasured in hospitals (n=5), government buildings (4), restaurants (10) and entertainment venues (10) in Seoul,Republic of Korea, using a common protocol. Field researchers completed an observational questionnaire todocument evidence of active smoking (the smell of cigarette smoke, presence of cigarette butts and witnessingpeople smoking) and administered a questionnaire regarding building characteristics and smoking policy.
Results: Indoor PM2.5 levels and air nicotine concentrations were relatively higher in monitoring sites wheresmoking is not prohibited by law. Entertainment venues had the highest values of PM2.5(μg/m3) and air nicotineconcentration(μg/m3), which were 7.6 and 67.9 fold higher than those of hospitals, respectively, where the valueswere the lowest. When evidence of active smoking was present, the mean PM2.5 level was 104.9 μg/m3, i.e., morethan 4-fold the level determined by the World Health Organization for 24-hr exposure (25 μg/m3). Mean indoorair nicotine concentration at monitoring sites with evidence of active smoking was 59-fold higher than at siteswithout this evidence (2.94 μg/m3 vs. 0.05 μg/m3). The results were similar at all specific monitoring sites exceptrestaurants, where mean indoor PM2.5 levels did not differ at sites with and without active smoking evidence andindoor air nicotine concentrations were higher in sites without evidence of smoking.
Conclusion: Nicotine wasdetected in most of our monitoring sites, including those where smoking is prohibited by law, such as hospitals,demonstrating that enforcement and compliance with current smoke-free policies in Korea is not adequate toprotect against SHS exposure.